Evaluating clinician sustainment of a Mediterranean‐style dietary pattern approach in routine care for coronary heart disease and type 2 diabetes utilizing Normalization MeAsure Development (NoMAD) instrument.
Background: A broader project translated evidence for a Mediterranean‐style dietary pattern (MDP) into clinicians' routine dietary care for type 2 diabetes and coronary heart disease in a public health service in Australia. This study aimed to determine sustainment of practice and what predicts clin...
| Publicado en: | Nutrition in Clinical Practice Vol. 40; no. 6; pp. 1552 - 1570 |
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| Autores principales: | , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Dec2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=189132314&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 189132314 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 08845336 IKQ jtl: Nutrition in Clinical Practice issn: 08845336 maglogo: N pubinfo: dt: Dec2025 vid: 40 iid: 6 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 189132314 188774088 189132314 189132314 10.1002/ncp.70055 189132314 ppf: 1552 ppct: 18 formats: tig: atl: Evaluating clinician sustainment of a Mediterranean‐style dietary pattern approach in routine care for coronary heart disease and type 2 diabetes utilizing Normalization MeAsure Development (NoMAD) instrument. aug: au: Mayr, Hannah L. Murray, Eryn Maher, Patrick Hayes, Lisa Wang, William Y. S. Kelly, Jaimon T. Palmer, Michelle Martin, Andrew Hickman, Ingrid J. affil: Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane Queensland,, Australia sug: subj: Diabetes Mellitus, Type 2 Diet Therapy Coronary Disease Diet Therapy Mediterranean Diet Dietary Patterns Physician Attitudes Evaluation Funding Source Human Male Female Descriptive Statistics Odds Ratio Confidence Intervals Univariate Statistics Multivariate Analysis Cross Sectional Studies Australia Questionnaires Exploratory Research Multiple Logistic Regression Dietitians Professional Role Implementation Science Long Term Care Summated Rating Scaling Allied Health Personnel Cognition Prospective Studies Nutrition Quantitative Studies Data Analysis Software T-Tests Wilcoxon Rank Sum Test Chi Square Test Male Female ab: Background: A broader project translated evidence for a Mediterranean‐style dietary pattern (MDP) into clinicians' routine dietary care for type 2 diabetes and coronary heart disease in a public health service in Australia. This study aimed to determine sustainment of practice and what predicts clinicians' routine use of an MDP approach 2 years after facilitated implementation. Methods: May 2021–October 2022 implementation strategies targeted multidisciplinary clinicians involved with dietary care. In October 2024 clinicians were surveyed using an adapted 14‐item Normalization Measure Development (NoMAD) questionnaire. Sustainment was defined as self‐rating ≥7 on a scale from 0 (not at all) to 10 (always) that recommending MDP is a "normal part of your work." Exploratory analyses, including logistic regression, identified whether clinician characteristics, NoMAD items, and theoretical constructs predicted sustainment. Results: Six dietitians and 61 other clinicians completed surveys, of which 100% and 52% self‐reported MDP practice sustainment, respectively. Multivariable models in the total cohort found that the odds of sustainment increased with higher scores in NoMAD items related to the perception that using an MDP approach was legitimately within the clinicians' role (odds ratio [OR], 15.7; 95% CI, 3.23–224), shared understanding of supporting evidence (OR, 3.79; 95% CI, 1.35–15.8), and the constructs cognitive participation (OR, 6.12; 95% CI, 1.78–27.9) and collective action (OR, 5.7; 95% CI, 1.48–30.1). Twenty‐seven clinicians commenced in the setting ≤2 years prior; within this group, MDP practice sustainment was significantly higher if MDP handover/orientation was received (71% vs 29%, P = 0.012). Conclusion: These data provide novel insights into impacts on sustainment of implemented evidence‐based dietary practice in the context of a multidisciplinary workforce with high turnover. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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